MEDICARE: ANTONIO J. DEL ROSARIO, M.D. INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	305R00000X	Preferred Provider Organization	35033390D	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245419688
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANTONIO J. DEL ROSARIO, M.D. INC.

Provider Business Mailing Address
First Line	:	6501 E LIVINGSTON AVE
Second Line	:
City	:	REYNOLDSBURG
State	:	OH
Zip	:	43068-3561
Country	:	US
Telephone Number	:	614-220-4188
Fax Number	:	614-220-4190

Provider Business Practice Location Address
First Line	:	849 HARMON AVE
Second Line	:	SUITE D
City	:	COLUMBUS
State	:	OH
Zip	:	43223-2411
Country	:	US
Telephone Number	:	614-220-4188
Fax Number	:	614-220-4190

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ANTONIO J DEL ROSARIO
Credential	:	M.D.
Telephone Number	:	614-220-4188

Provider Enumeration Date	:	11/02/2007
Last Update Date	:	12/11/2007

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